Alzheimer's Weekly - A Caregiver's Dementia Introduction

Ads

Enjoy Mediterranean Diet Food. Free shipping on orders over $50

Newsletter

A Caregiver's Dementia Introduction

Week of January 18 - January 24, 2009

Transcript included below:

Cutting edge science and research across Europe now - in Futuris.

Sylvia: "I think the worst thing is lack of a partnership. Whereas before, we made decisions together, now I have to do all of that. And you don't have the companion that you had for all those years."

About three years ago, Sylvia's 79-year-old husband Peter began showing signs of memory loss. A former design engineer with a zest for life, he designed and built many projects at home. He was also an enthusiastic member of the scouting movement. But then he lost his drive and gradually his ability to cope on his own. Eventually, he came to R.I.C.E., the Research Institute for the Care of the Elderly in Southwest England, where he was diagnosed with Alzheimer's disease.

Sylvia: "He does not remember his children at all, or his grandchildren, or his brother and sister. He welcomes them into the house because they are friendly to him and he likes to see them, but he does not remember them."

Peter is now part of a trial testing new drugs to relieve the symptoms of Alzheimer's disease. It is one of many research strands being conducted in Europe which are trying to further the understanding of age-related diseases and relieve the burden on patients and their carers.

Roy Jones, Director, Research Institute for the Care for the Elderly:

"As the disease progresses, people become more dependent, people need more support. Often people develop problems with behavior, they may become agitated, they may become anxious, they may not sleep so well. Eventually this is such a stress that the family caregiver needs support from outside."

Alzheimer's disease was once thought to be a natural consequence of aging and was comparatively rare. But now it is causing concern among medical authorities around the world. The disease mostly effects those over 65, and risk factors increase as people age. Estimates put the number of sufferers worldwide at about 26 million. But as the world's population ages, it has been estimated that by 2050, this number will have increased four times. At the Karolinska Institute in Stockholm, Professor Bengt Winblad is the Director of the Alzheimer's Disease Research Center.

Professor Bengt Winblad, Director, Alzheimer's Disease Research Center:

Professor Winblad explaining the effects of dementia on the brain.

"The disease process usually starts in these more yellow colored parts. We call them the temporal lobe. And here, in the bottom, you have a structure called the hippocampus. And then the pathology spreads up to the parietal lobe, the more blue-colored part, and then moves all over the cortical parts. Of course, this also relates to the clinical symptoms. Here you have much of the memory function. Here you have much of the language capacity. So the memory is effected, the language is effected a bit later in the disease process."

The pathological symptoms of Alzheimer's disease are easily recognizable in samples of brain tissue. The dark flecks are known as plaques and tangles. A close-up of a plaque shows the accumulation of a protein called beta-amyloid, which packs around neurons, blocking their signals.

These are tangled nerve endings typical of the disease. Compare those with a section of healthy brain tissue from a patient of similar age.

Professor Winblad: "Today we know so much more than we knew 20 years ago. 20 years ago we had no drug treatment, the care was not optimal, we had no drugs on the market. Today, we have the first generation of drugs. We know that this beta-amyloid formation is important, and the care is much better."

Following the death of her father from Alzheimer's disease, Barbara Fahlen has come to the Research Center to have herself tested. Although only 62, she felt her mind was failing. In fact, tests of her memory and grasp of spatial relationships showed that she did not have the disease. She will return in 18 months.

Barbara Fahlen: "I just wanted to check out if it was just ordinary stress. You have a lot of things to think about, and you are only taking what you think is important and you forget the less important stuff. But I thought I started to forget appointments. When I walked upstairs to get a cup of coffee and I came upstairs and I said, 'What am I doing here? What was it I was going to do?' And sometimes I forget and I have to walk downstairs again and start from the beginning."

Testing involving memory quizzes is the first step in establishing a diagnosis. Early diagnosis is important to establish whether there may be other causes of cognitive impairment.

Miia Kivipelto, Associate Professor, Alzheimer's Research Institute:

"We are doing many memory tests, so that we can really see if there are some memory problems. And then we have today some technical tools we can use to support our diagnosis. We often do MRI neuro-imaging, so that we can see how the brain structure is."

Magnetic Resonance Imaging, or MRI, has proven itself to be an invaluable diagnostic tool for doctors researching Alzheimer's disease as well as many other conditions. By placing the patient in a powerful magnetic field, 3-D images can be obtained of the tissue being investigated. MRI scans clearly show what is happening in the brain. The scan on the left shows atrophy and shrinkage typical of advanced Alzheimer's disease, while the brain on the right is normal.

But while researchers race to find a treatment, is there anything we can do to protect ourselves?

Professor Kivipelto:

"Now we know there are many lifestyle-related factors. Physical activity, active lifestyle in general, mental training, social activity - these all protect against Alzheimer's disease. Also vascular factors like high-blood-pressure, high cholesterol, diabetes, obesity - all these are factors that increase the risk of Alzheimer's disease. So take care of all these kinds of risk factors. All that is good for the heart is also good for the brain."

Europe's population is getting older. The number of over-65s is anticipated to rise from around 15% of the population to 22% in 2025. That means the incidence of Alzheimer's is also going to rise, putting a burden on patients, carers and medical resources.

Barbara Fahlen: "In the end, he was thin, like a little bird in his wheelchair. I had to force myself to go and visit him. It broke my heart to see him like this. Really."

Professor Winblad: "If we don't find a cure or a treatment for Alzheimer's disease, I'm afraid many healthcare systems will collapse under this pressure."

Syliva: "You adapt. But it has its downsides, yes. Lack of freedom. And taking a very long time to explain any small thing for him to do."

CAREGIVING ARTICLES ON THIS SITE

Caregiving Center

Read articles about caregiver support groups, the 7 stages, care management, protection and self-care.

Caregiving News

News on caregiving benefits and pitfalls to avoid, seasonal tips, important research and new caregiving programs.

The 36-Hour Day

"Continues to be the 'bible' of recommendation for any caregiver whose family member suffers from a dementia such as Alzheimer's." -- Bookwatch

"The best guide of its kind." -- Chicago Sun-Times

"An admirably realistic guide to caring for people with Alzheimer's." -- Michael Greenberg, New York Review of Books